Ask The Expert - 10 Tips on...

How to Assess a Nursing Home

1. Is there stability in leadership?
   
2. What are the staffing ratios? How much turnover occurs?
   
3. How many RNs work there--is there RN coverage on every unit, every shift? Are there specialists (nurse practitioners, geriatrics-trained MD, therapists, pharmacist, gero-psychiatrist) for managing care--and anticipating and/or preventing problems before they occur. Is there good medical surveillance?
   
4. Are residents frequently transferred to the hospital; is there good support for a resident's advance directive (living will)?
   
5. Is there commitment to a resident-centered philosophy and a home-like environment? Pets? Outings? Activities?
   
6. What is the food like and the dining experience?
   
7. What efforts are made to individualize care? Assure personal preferences and routines?
   
8. Do families have easy access to a resident care coordinator when questions/problems arise?
   
9. Is there a palliative care program? Are there special programs for persons with dementia?
   
10. Will someone provide a tour of the facility for potential families/residents?
    
11. Are there regular family care conferences/communications with families? can one talk to other residents and families?
    
12. Overall, what does the place look like, feel like, smell like, sound like--is it a "warehouse," or is there some sense of community and of genuine caring.

Neville E Strumpf, PhD, RN, FAAN
Edith Clemmer Steinbright Professor in Gerontology, and Director of the Center for Gerontologic Nursing Science